Death and Near Death from Cardiac Arrest during the Boston Marathon

Abstract

The Boston Marathon has been run for 115 years during which there were three sudden cardiac arrests. The most recent was a near death avoided by rapid cardiopulmonary resuscitation (CPR) and defibrillation. Awareness of the dangers of participating in a marathon, the risk factors associated with sudden death during competition, and the life-saving importance of rapid CPR and defibrillation are essential for participants and event organizers. Available records and reports of the three known cases of cardiac arrest during the Boston Marathon were examined. These cases were identified by representatives of the Boston Athletic Association, which has organized each marathon since its inception. Pertinent literature was reviewed and new information was obtained during interviews of witnesses and rescuers. The data were analyzed in search of shared risk factors for cardiac arrest, death, and the optimal requirements for survival. In 115 years, there were two cardiac deaths and one near death from cardiac arrest. A history of coronary artery disease, advanced age, and prolonged race time are risk factors for sudden cardiac arrest. Rapid application of CPR and defibrillation are essential for survival. Prevention or reduction of life-threatening cardiac incidents during marathon races might be achieved if participants of advanced age or with a history of coronary artery disease seek medical clearance prior to entering an event. Those with coronary risk factors should have a discussion with their physician. Availability of trained personnel and defibrillators are important considerations in marathon planning.

An update on the Boston Marathon as a research laboratory

“…The consensus from these reports is that acute cardiac events are rare [5,7], occur often [10], but not always due to acute coronary thrombosis [5], and that prompt resuscitation via bystanders or professionals is a critical element in survival [5,7]. Furthermore, the observation that 69% of the events occurred in the last quartile 6 miles of the race [5] suggests that this portion requires special attention from emergency personnel.…”

“…Others [7] reviewed three cases of death or cardiac arrest that occurred during the BAA. These include the collapse and subsequent death of a 44-year-old man in 1973 published in Annals of Internal Medicine, the death of a 61-year-old man with suspected ASCVD in 1996 [8,9], and the resuscitation of a 63-year-old man in 2010.…”

Factores de riesgo del comportamiento y preparación de aficionados inscritos a carreras atléticas de fondo de 18 a 64 años en Bogotá, Colombia, 2014

“…Varios estudios han reportado 1,2,7,35 los posibles riesgos cardiovasculares de los corredores recreativos, que pasan desapercibidos o se presentan súbitamente, a menos que se realicen estudios que detecten enfermedades crónicas 1 o factores de riesgo del comportamiento 1,36,37 . La administración de cuestionarios es un método costo-efectivo, que genera información sobre estos antecedentes, previos a la exposición a un mayor esfuerzo físico, que afectarían la salud antes, durante e incluso, después de la carrera.…”

“…En una carrera de características similares se encontró una prevalencia de riesgo por Par-Q+ de 14,9% para mujeres y 13,5% para hombres 34 et al 36 evidenciaron que el reconocimiento previo de los riesgos por los corredores aficionados con factores de riesgo coronario y un acercamiento con el médico aumentaría la seguridad en la práctica. Los resultados demuestran que la revisión previa de morbilidad sentida es una tarea necesaria en la antesala de eventos deportivos 7,26,35,41 .…”

Sudden Cardiac Death in Athletes: Tips for Prevention

“…Whether young or old, they all want to participate in a marathon to prove themselves (1). Along with the aging population, a significant number of individuals are playing sports in their free time.…”